Gapcom 4/14 Drug Abuse Teratogenicity (X)

Front 1

addiction vs physical dependence

Back 1

physical depedence can, and often does occur independently of psychological dependence. physical depedence is NOT a criterion for addiction. drug abuser has an addiction which leads to chronic use. a legitimate patient has chronic use. from either way, chronic use leads to tolerance and then to physical dependence.

Front 2

define addiction and gives criteria of disorder

Back 2

mental disorder, with psychological dependence. criteria: 1. compulsive disorder, 2.substantial amount of time thinking about it, doing it, and trying to acquire it, 3.high rate of recidivism (relapse)

Front 3

connection btw withdrawal rxns and physical depedence

Back 3

withdrawal rxns occur when drug is lowered in dosage or is terminated. severity depends on: amount used per day, length of time drug has been used, length of time allowed for withdrawal. range mild, mod, to severe

Front 4

Drug testing for 'use' vs 'impairment'

Back 4

'use' - urine testing acceptable but has limitations: 1. false positives, 2. nonspecificity, 3. false accusation of drug use (marijuana second-hand, narcotics biotransformed), 4. prolonged elimination, if chronic user may not indicate recent use bc longer to leave system, 5. no relationship to impairment bc cannot correlate substance in urine to some degree of impairment, 6. constitutional restriction - probable cause 4th amendment

'impairment' only a blood test is valid (or a breath test in case of alcohol)

Front 5

define physical dependence

Back 5

prolonged use can trigger an adaptive process. tolerance develops when cells change (up/down regulation). physical depedence begins with occurrence of tolerance. can become dependent on psyhchoactive drugs such as Valium, but to other meds such as propanolol (B stimulant when removed cause CV events)

Front 6

explain principles of teratology

Back 6

1. selectivity - can affect fetal devt without disturbing placental function or serious maternal toxicity
2. sensitive periods
NOT first two weeks after conception. Third week after conception to third month during early organogenesis. 3. malformations - single teratogen can produce multiple malformations (ex. rubella eye, ear, brain, heart). many different teratogens can produce the same malformation.
4. experimental teratogenesis - animal studies do not always correlate bc species and strain dependent.
5. genetic-environmental interaction - genotype of the fetus may determine relative susceptibility to a teratogen.

Front 7

differentiate teratogenesis in humans from experimental animals

Back 7

although many chemicals are teratogenic in animals, few compounds (ex. thalidomide) have been proven to be teratogenic in humans. any drug therapy should be avoided unless absolutely necessary during pregnancy. also in general women should not be taking unncessary drugs during reproductive years bc by time of pregnancy, the critical (early) period of organogenesis may have already occurred.

Front 8

LIST the principles of teratology

Back 8

1. selectivity
2. sensitive periods
3. malformations
4. experimental teratogenesis
5. genetic-environmental interaction